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The Myth of Mental Illness: 50 years after publication: What does it mean today?

Published online by Cambridge University Press:  13 June 2014

Brendan D Kelly ,
Pat Bracken ,
Harry Cavendish ,
Niall Crumlish ,
Seamus MacSuibhne ,
Thomas Szasz  and
Tim Thornton
Brendan D Kelly*
Affiliation:
Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7, Ireland
Pat Bracken
Affiliation:
Mental Health Services, Bantry, West Cork, Ireland
Harry Cavendish
Affiliation:
Dublin, Ireland
Niall Crumlish
Affiliation:
St. Davnet's Hospital, Monaghan, Ireland
Seamus MacSuibhne
Affiliation:
Department of Psychiatry and Mental Health Research, St Vincents University Hospital, Dublin, Ireland
Thomas Szasz
Affiliation:
State University of New York Upstate Medical University, 750 East Adams Street, Syracuse 13210, New York, USA
Tim Thornton
Affiliation:
International School for Communities, Rights and Inclusion, University of Central Lancashire, England
*
*Correspondence E-mail: [email protected]
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Abstract

In 1960, Thomas Szasz published The Myth of Mental Illness, arguing that mental illness was a harmful myth without a demonstrated basis in biological pathology and with the potential to damage current conceptions of human responsibility. Szasz's arguments have provoked considerable controversy over the past five decades. This paper marks the 50th anniversary of The Myth of Mental Illness by providing commentaries on its contemporary relevance from the perspectives of a range of stakeholders, including a consultant psychiatrist, psychiatric patient, professor of philosophy and mental health, a specialist registrar in psychiatry, and a lecturer in psychiatry. This paper also includes responses by Professor Thomas Szasz.

Szasz's arguments contain echoes of positivism, Cartesian dualism, and Enlightenment philosophy, and point to a genuine complexity at the heart of contemporary psychiatric taxonomy: how is ‘mental illness’ to be defined? And by whom? The basis of Szasz's doubts about the similarities between mental and physical illnesses remain apparent today, but it remains equally apparent that a failure to describe a biological basis for mental illness does not mean there is none (eg. consider the position of epilepsy, prior to the electroencephalogram). Psychiatry would probably be different today if The Myth of Mental Illness had not been written, but possibly not in the ways that Szasz might imagine: does the relentless incarceration of individuals with ‘mental illness’ in the world's prisons represent the logical culmination of Szaszian thought?

In response, Professor Szasz emphasises his views that “mental illness” differs fundamentally from physical illness, and that the principal habits the term ‘mental illness’ involves are stigmatisation, deprivation of liberty (civil commitment) and deprivation of the right to trial for alleged criminal conduct (the insanity defence). He links the incarceration of the mentally ill with the policy of de-institutionalisation (which he opposes) and states that, in his view, the only limitation his work imposes on human activities are limitations on practices which are conventionally and conveniently labelled ‘psychiatric abuses’.

Clearly, there remains a diversity of views about the merits of Szasz's arguments, but there is little diminution in his ability to provoke an argument.

Type
Perspective
Information
Irish Journal of Psychological Medicine , Volume 27 , Issue 1 , March 2010 , pp. 35 - 43
Copyright
Copyright © Cambridge University Press 2010

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References

1.Szasz, TS. The myth of mental illness. The American Psychologist 1960; 15: 113–118.CrossRefGoogle Scholar
2.Szasz, T. The myth of mental illness: foundations of a theory of personal conduct. New York: Dell Publishing, 1961.Google Scholar
3.Szasz, T. The myth of mental illness: foundations of a theory of personal conduct. London: Paladin, 1972.Google Scholar
4.Szasz, T. The myth of mental illness (2nd ed.). New York: Harper Collins, 1974.Google Scholar
5.Szasz, TS. Liberation by oppression: a comparative study of slavery and psychiatry. New Brunswick, NJ: Transaction Publishers, 2002.Google Scholar
6.Szasz, T. Reply to Bentall. In: Schaler, JA (Ed). Szasz under fire. Chicago: Open Court, 2004:321–326Google Scholar
7.Szasz, T. The medicalization of everyday life. Syracuse, New York: Syracuse University Press, 2007.Google Scholar
8.Schaler, JA (Ed). Szasz under fire. Chicago: Open Court, 2004.Google Scholar
9.Fulford, KWM. Values-based medicine: Thomas Szasz's legacy to twenty-first century psychiatry. 2004: 57–92.Google Scholar
10.Bentall, R. (2004) Sideshow? Schizophrenia as construed by Szasz and the neo-Kraepelinians. In: Schaler, JA (Ed). Szasz under fire. Chicago: Open Court, 2004: 310–320.Google Scholar
11.Kendell, RE. The myth of mental illness. In: Schaler, JA (Ed). Szasz under fire. Chicago: Open Court, 2004: 29–48Google Scholar
12.Percival, RS. Persons and Popper's world 3: do humans dream of abstract sheep? In: Schaler, JA (Ed). Szasz under fire. Chicago: Open Court, 2004: 119–130Google Scholar
13.Clare, AW. Psychiatry in dissent: controversial issues in thought and practice. London: Tavistock Publications, 1976.Google Scholar
14.Kelly, BD, Feeney, L. Psychiatry: no longer in dissent? Psychiatric Bull 2006; 30: 344–345.Google Scholar
15.Panksepp, J (Ed). Textbook of biological psychiatry. Hoboken, NJ: WileyBlackwell, 2003.Google Scholar
16.Fannon, D. E-interview: Thomas Szasz. Psychiatric Bull 2005; 29: 120.CrossRefGoogle Scholar
17.Szasz, T. My madness saved me: the madness and marriage of Virginia Woolf. New Brunswick, NJ: Transaction Publishers, 2006.Google Scholar
18.Fulford, KWM, Thornton, T, Graham, G. Oxford textbook of philosophy and psychiatry. Oxford: Oxford University Press, 2006.CrossRefGoogle Scholar
19.Kuhn, T. The structure of scientific revolutions. Chicago: University of Chicago Press, 1962.Google Scholar
20.Buchanan-Barker, P, Barker, P. The convenient myth of Thomas Szasz. J Psychiatric Ment Health Nurs 2009; 16: 87–95.CrossRefGoogle ScholarPubMed
21.Clarke, L. Sacred radical of psychiatry. J Psychiatric Ment Health Nurs 2007; 14: 446–453.CrossRefGoogle ScholarPubMed
22.Horwitz, AV, Wakefield, JC. The loss of sadness: how psychiatry transformed normal sorrow into depressive disorder. New York: Oxford University Press, 2007.CrossRefGoogle Scholar
23.Lane, C. Shyness: how normal behavior became a sickness. New Haven, CT: Yale University Press, 2007.Google Scholar
24.Angell, M. Drug companies and doctors: a story of corruption. New York Review of Books 2009; 56. www.nybooks.com/articles/22237 (accessed Jan 8th 2009).Google Scholar
25.Rissmiller, DJ, Rissmiller, JH. Evolution of the antipsychiatry movement into mental health consumerism. Psychiatric Serv 2006; 57: 863–866.CrossRefGoogle ScholarPubMed
26.Oaks, D. The evolution of the consumer movement. Psychiatric Serv 2006; 57: 1212.CrossRefGoogle ScholarPubMed
27.Laing, RD. The politics of experience and the bird of paradise (pp. 104-105). London: Penguin Books, 1990: 104–105.Google Scholar
28.Falconer, MA. Clinical manifestations of temporal lobe epilepsy and their recognition in relation to surgical treatment. BMJ 1954; 2: 939–944.CrossRefGoogle ScholarPubMed
29.Slater, E. Diagnosis of ‘hysteria’. BMJ 1965; 1(5447): 1395–1399.CrossRefGoogle ScholarPubMed
30.Torrey, F. Jails and prisons – America's new mental hospitals. Am J Public Health 1995; 85: 1611–1613.CrossRefGoogle ScholarPubMed
31.Eysenck, HJ. Classification and the problems of diagnosis. In: Eysenck, HJ (Ed). Handbook of Abnormal Psychology. London: Pitman Medical, 1968: 1–31Google Scholar
32.Persaud, R. Review of liberation by oppression: a comparative study of slavery and psychiatry. Br J Psychiatry 2003; 182: 273.CrossRefGoogle Scholar
33.Boorse, C. On the distinction between disease and illness. Philosophy and Public Affairs 1975; 5: 49–69.Google Scholar
34.Kendell, RE. The concept of disease. Br J Psychiatry 1975; 137: 305–315.CrossRefGoogle Scholar
35.Scadding, JG. Diagnosis: the clinician and the computer. Lancet 1967; 2(7521): 877–882.CrossRefGoogle ScholarPubMed
36.Kendell, RE. The distinction between personality disorder and mental illness. Br J Psychiatry 2002; 180:110–115.CrossRefGoogle ScholarPubMed
37.Szasz, TS. Second commentary on Aristotle's function argument. Philosophy, Psychiatry and Psychology 2000; 7:3–16.Google Scholar
38.Fulford, KWM. Praxis makes perfect: illness as a bridge between biological concepts of disease and social conceptions of health. Theoretical Med 1993; 14: 323–324.CrossRefGoogle ScholarPubMed
39.Austin, JL. A plea for excuses. Proceedings of the Aristotlean Society 1956-1957; 57:1–30.CrossRefGoogle Scholar
40.Locker, D. Symptoms and illness. London: Tavistock Publications, 1981: 92–132.Google Scholar
41.Berlin, I. Freedom and its betrayal: six enemies of human liberty. London: Pimlico, 2003.Google Scholar
42.Feinstein, AR. In: Szasz T. Pharmacracy: Medicine and Politics in America (back cover). Westport, CT: Praeger, 2001. (Reprint, Syracuse: Syracuse University Press, 2003.)Google Scholar
43.Szasz, T. The Manufacture of Madness: A Comparative Study of the Inquisition and the Mental Health Movement. Syracuse: Syracuse University Press, 1970/1997.Google Scholar
44.Szasz, T. Coercion as Cure: A Critical History of Psychiatry. Brunswick, NJ: Transaction, 2003.Google Scholar
45.Szasz, T. Psychiatry: The Science of Lies. Syracuse: Syracuse University Press, 2008.Google Scholar
46.Szasz, T. Insanity: The Idea and Its Consequences. Syracuse: Syracuse University Press, 1988/1998.Google Scholar
47.Szasz, T. Cruel Compassion: The Psychiatric Control of Society's Unwanted. Syracuse: Syracuse University Press, 1994/1998.Google Scholar
48.Jaspers, K. General Psychopathology, 7th edition. Translated by Hoenig J, Hamilton MW. Chicago: University of Chicago Press, 1913.Google Scholar
49.McHugh, PR, Slavney, PR. The Perspectives of Psychiatry. Baltimore: Johns Hopkins University Press, 1998: 5–6.CrossRefGoogle Scholar
50.Porter, R. Madness: A Brief History. Oxford: Oxford University Press, 2002: 1–3. (See also: Porter R. “Introduction.” In: Porter R, Wright D (Eds). The Confinement of the Insane: International Perspectives, 1800-1965. Cambridge: Cambridge University Press, 2003: 2).Google Scholar